Return to School Declaration Form

This form is to be used when children are returning to the setting/ school after any absence.

Declaration:

I have no reason to believe that my child has infectious disease and I have followed all medical and public health guidance with respect to exclusion of my child from educational facilities.

Child's Name

First Name

Last Name

Manager's Name

Pól Ó Síodhcháin

Parent/ Guardian Name

First Name

Last Name

Name of Setting

Millstreet Community School

Signed by

Signature Date (dd/mm/yy)

(dd/mm/yy)